Provider Demographics
NPI:1134303654
Name:WEINTRAUB, JILL D (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:D
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:LANDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:30 DORIS LN
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1000
Mailing Address - Country:US
Mailing Address - Phone:917-658-0649
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:30 DORIS LN
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1000
Practice Address - Country:US
Practice Address - Phone:917-658-0649
Practice Address - Fax:914-223-7006
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216398207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine